The symptoms which follow the affection of the alimentary canal in
cholera are exactly those which this affection is adequate, and, indeed,
could not fail to produce. The analyses which have been made of the
blood of cholera patients, show that the watery fluid effused into the
stomach and bowels is not replaced by absorption, or is replaced only to
a small extent. The analyses of Dr. O’Shaughnessy and others, during the
cholera of 1831–32, show that the amount of water in the blood was very
much diminished in proportion to the solid constituents, and that the
salts of the blood were also diminished. The analyses of Dr. Garrod and
Dr. Parkes, in the spring of 1849, were more numerous and exact.[3] The
amount of water in the blood of healthy persons is on the average 785
parts in 1000; whereas, in the average of the analyses performed by Drs.
Garrod and Parkes, it was only 733 parts, while the amount of solid
constituents of the blood, relatively to the water, was increased from
215—the healthy standard—to 267. The globules, together with the albumen
and other organic constituents of the serum, amount in the healthy state
to 208 parts in 1000, while in the blood of cholera patients they
amounted to 256 parts. The saline constituents in 1000 parts of blood
are somewhat increased, on account of the great diminution of water;
but, when estimated in relation to the other solid ingredients, or to
the whole quantity existing in the healthy body, the amount is
diminished. Dr. Garrod is of the opinion that a chemical analysis will
determine whether or not a specimen of blood has been derived from a
cholera patient.
The stools and vomited matters in cholera consist of water, containing a
small quantity of the salts of the blood, and a very little albuminous
substance. The change in the blood is precisely that which the loss by
the alimentary canal ought to produce; and, indeed, it is physically
impossible that the alteration in the blood can be caused in any other
way. The sweating which takes place in an advanced stage of the disease
may increase the density of the blood to a trifling extent; but it does
not come on till the blood is already altered, and it is only a
consequence of the diminished force of the circulation, like the
sweating met with in collapse from hæmorrhage or severe injuries, and in
faintness from venesection.
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